Evidence map›Paper›PMID 41838140›Full record

SynthesisEuropean archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery2026

A comprehensive systematic review on the efficacy, safety, and tolerability of awake procedures for chronic rhino-sinusitis.

Domiziana Nardelli, Francesco Iafrati, Antonio Moffa, Benedetta Cristalli, Iman Al Afifi, Lorenzo Sabatino, Ofer Jacobowitz, Peter M Baptista, Manuele Casale

Abstract readSystematic Review
PubMed Publisher
In one paragraph

Synthesis in European archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors.

Domiziana NardelliFondazione Policlinico, Università Campus Bio-Medico, Via Álvaro del Portillo 200, Rome, 00128, Italy.
Francesco IafratiFondazione Policlinico, Università Campus Bio-Medico, Via Álvaro del Portillo 200, Rome, 00128, Italy.
Antonio MoffaFondazione Policlinico, Università Campus Bio-Medico, Via Álvaro del Portillo 200, Rome, 00128, Italy. a.moffa@policlinicocampus.it.ORCID http://orcid.org/0000-0002-6181-8194
Benedetta CristalliSchool of Medicine, Università Campus Bio-Medico di Roma, Via Álvaro del Portillo 21, 00128, Rome, Italy.
Iman Al AfifiFondazione Policlinico, Università Campus Bio-Medico, Via Álvaro del Portillo 200, Rome, 00128, Italy.
Lorenzo SabatinoFondazione Policlinico, Università Campus Bio-Medico, Via Álvaro del Portillo 200, Rome, 00128, Italy.
Ofer JacobowitzSleep Department, ENT and Allergy Associates, New York, NY, USA.
Peter M BaptistaENT Department, Al Zahra Private Hospital, Dubai, United Arab Emirates.
Manuele CasaleFondazione Policlinico, Università Campus Bio-Medico, Via Álvaro del Portillo 200, Rome, 00128, Italy.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeThis systematic review consolidates current evidence on the efficacy, safety, and tolerability of awake, office-based procedures for chronic rhinosinusitis (CRS). It aims to evaluate whether these minimally invasive interventions performed under local anesthesia are viable alternatives to conventional sinus surgery under general anesthesia.

methodsA systematic search of PubMed/MEDLINE, Google Scholar, and Scopus databases was performed through November 2025, following PRISMA guidelines. Studies were selected using the PICOS framework, including adult patients undergoing in-office procedures (e.g., balloon sinus dilation, endoscopic sinus surgery, polypectomy, steroid-eluting implant placement) for CRS. Data were extracted and narratively synthesized due to heterogeneity.

resultsEleven studies involving 1,283 patients were included. The procedures demonstrated significant and sustained improvements in patient-reported (SNOT-22, SNOT-20, NOSE, VAS) and objective (Lund-Mackay, Nasal Polyp Score) outcomes. Complication rates were low, with minor adverse events. Intraoperative pain was generally mild, tolerability was high (82-95%), and patients reported rapid recovery (often within 48 h) and high satisfaction (72-95% willing to repeat the procedure).

conclusionAwake sinus procedures are an effective, safe, and well-tolerated treatment option for selected CRS patients. They offer significant symptom relief, high patient satisfaction, and rapid recovery while avoiding general anesthesia. These techniques represent a transformative, patient-centered, and resource-efficient component of modern rhinology.

Indexed as

Ambulatory Surgical ProceduresAnesthesia, LocalRhinitisRhinosinusitisSinusitisChronic DiseaseEndoscopyHumansTreatment OutcomeWakefulnessAwake surgeryBalloon sinuplastyChronic rhinosinusitisEndoscopic sinus surgeryOffice-based procedures

Identifiers

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.